The assessment of musculoskeletal pain

Department of Medicine, Division of Rheumatology, Women’s College Hospital, University of Toronto; Women’s College Research Institute, Women’s College Hospital, University of Toronto, ON, Canada. g.hawker@utoronto.ca

Abstract

Musculoskeletal (MSK) pain has a major impact on people’s quality of life. Chronic MSK pain causes sleep interruption, fatigue, depressed mood, activity limitations and participation restrictions. The impact of MSK pain is influenced by contextual factors, including comorbidity, arthritis coping efficacy and access to MSK care. Thus, MSK pain assessment warrants a bio-psychosocial perspective that includes pain, its downstream effects and contextual factors. Such an approach should incorporate elicitation of symptoms using patient-report questionnaires and physical examination to help localize the pain and assess for signs of inflammation, tenderness on palpation, pain on motion, joint instability and malalignment. Using such an approach to the assess chronic pain in MSK conditions has potential to improve our ability to target the right treatment to the right patient, resulting in improved outcomes.